The nutrient omentum free flap: revascularization with vein bypasses and greater omentum flap in severe arterial ulcers.

Microvascular transfer of the omentum provides well-vascularized and pliable tissue but has not widely been used in vascular extremity reconstruction because of the potentially high donor site morbidity caused by the necessary laparotomy. Laparoscopic minimally invasive harvest of a free greater omentum flap and microsurgical transfer of this tissue with split skin grafts on top and connected to sequential vein bypasses may be a an interesting new modality when other reconstructive options are absent or scarce. We report this novel technique in a patient with arterial occlusive disease and an extensive and circular ulcer of the lower extremity.